Journal of Ideas in Health
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Topical corticosteroids in the treatment of acute sunburn: a systematic review
Get PDFBackground: Acute sunburn is a prevalent dermatological issue, particularly affecting individuals with fair skin types I-III. It is characterized by erythema, edema, and discomfort due to ultraviolet (UV) radiation exposure. Topical corticosteroids are commonly used for their anti-inflammatory properties, but their efficacy in sunburn treatment is debated due to limited high-quality evidence from randomized controlled trials (RCTs). This study aims to assess the efficacy of topical corticosteroids in relieving symptoms and inflammation of sunburn.
Methods: A systematic review was conducted by searching PubMed, Web of Science, ProQuest, Scopus, and Cochrane Central Register of Controlled Trials (CENTRAL) for studies published up to April 30, 2024. Keywords included combinations of terms related to corticosteroids, topical application, and sunburn. Studies were selected based on PRISMA 2020 guidelines, focusing on adult patients treated with topical corticosteroids compared to placebo. Data extraction and quality assessment were independently performed by two researchers using the Cochrane Collaboration’s Risk of Bias tool.
Results: The review included six RCTs with a total of 339 participants, aged 18-68 years, conducted in Europe and the USA. Various topical corticosteroids were studied, including methylprednisolone aceponate, hydrocortisone 17-butyrate, and hydrocortisone-21-acetate. Treatment durations ranged from single applications to twice daily for seven days. The results demonstrated that prolonged treatment with topical corticosteroids significantly reduced sunburn symptoms such as erythema and pain. When applied for seven days, treated areas showed lower sunburn reaction scores and reduced inflammation compared to untreated areas. Early application of corticosteroids, particularly within 6 hours post-exposure, was more effective than later applications. Histological analyses supported these findings, showing improvements in epidermal thickness and reduced dermal inflammation in treated areas.
Conclusion: Topical corticosteroids can effectively alleviate acute sunburn symptoms and aid skin recovery by targeting inflammatory pathways. Their efficacy is enhanced with prolonged and early application. Further research is needed to optimize treatment protocols and assess long-term effects to fully realize the therapeutic potential of corticosteroid therapy in managing acute sunburn
Gender disparities in lymphocyte counts and cytokine expression in COVID-19
Get PDFBackground: This study seeks to assess gender differences in the severity of COVID-19 infection, which have been noted in different regions during the early stages of the pandemic.
Methods: A cross-sectional study conducted at Baquba Teaching Hospital in Diyala, Iraq, from October 1st to December 31st, 2020, included 132 confirmed COVID-19 patients. These patients underwent a comprehensive set of routine laboratory tests, including complete blood count, blood biochemistry, and D-dimer assessment. Statistical analysis was carried out using SPSS-20, with significance set at p < 0.05.
Results: The study included patients with a mean age of 45.61 (±11.32) years, predominantly male (63.0%), residing in urban areas (57.6%), and presenting with comorbidities (78.8%). All patients exhibited positive results on CT scans (100%) and CRP tests (100%). However, PCR testing confirmed COVID-19 infection in 87.2% of cases, with 12.8% testing negative. Among males, there was a significant increase in IL-6 and IL-10 levels (42.57 ± 7.64 pg/ml and 255.27 ± 21.03 pg/ml) compared to females (16.43 ± 4.19 pg/ml and 187.48 ± 20.35 pg/ml), with p-values <0.001 and 0.003, respectively. Conversely, there was no significant difference in IFN-ɣ levels between males (165.73 ± 16.54 pg/ml) and females (176.12 ± 17.10 pg/ml), with a p-value of 0.105. However, lymphocyte levels were significantly lower in males (4.79 ± 0.85%) compared to females (14.01 ± 1.36%), with a p-value <0.001.
Conclusion: Overall, COVID-19 affects males more severely than females, with males showing weaker immune responses and higher levels of inflammatory cytokines like IL-6 and IL-10. While IFN-ɣ levels do not differ significantly between genders, males have lower lymphocyte counts compared to females
Primary testicular lymphoma in undescended testis of a middle-age man: a case report
Get PDFBackground: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extra-nodal non-Hodgkin lymphoma (NHL), accounting for <5.0% of testicular malignancies and 1.0% to 2.0% of NHL cases with a median age at diagnosis of 66 to 68 years. PTL accounts for 1–9% of testicular malignancies and 1–2% of NHLs. There are a handful of described lymphomas in the literature affecting normally positioned testis of aged men, yet none were reported in a cryptorchid middle-aged man. PTL is an extremely aggressive malignancy with poor progression-free survival and overall survival.
Case presentation: A 47-year-old man presented to the urology clinic complaining of multiple painless swellings in the neck and groins. He also complains of back pain, drenching night sweats, a swollen right lower limb, constipation, anorexia, weight loss, and occasional vomiting. The illness\u27s duration is 2 months. He had a right inguinal testis. Histology examination of the excised testis and lymph nodes revealed an advanced “diffuse large beta-cell lymphoma” in both. The patient was referred for oncology care.
Conclusion: It is an extremely rare case of Diffuse Large B-Cell Lymphoma (DLBCL) in the undescended testis of a middle-aged man. To the best of our knowledge, this is the first published case of its kind about the tumor\u27s type, testis anomaly, and patient\u27s age
Metagenomics screening of viruses in Arusha, north Tanzania: a one health perspective across wild rodents, domestic dogs and humans
Get PDFBackground: One of the most significant and perilous challenges faced by African societies, including Tanzania, is the public health threat posed by zoonotic viruses. This study aimed to ascertain the presence of viruses in wild rodents, domestic dogs, and humans who shared the same environment.
Methods: A cross-sectional study was conducted in the Ngorongoro district from January to September 2022. Metagenomics next-generation sequencing technologies, including Illumina (MiSeq) and Oxford Nanopore (MinION), were employed to identify viruses in 530 blood samples collected from 200 humans, 230 wild rodents, and 100 domestic dogs. The captured wild rodents belonged to various species: Mastomys spp (n=87), Ratus spp (n=45), Avicanthis spp (n=40), Arcomys spp (n=28), Mus spp (n=16), and Field mice (n=14). The taxonomic classification of viruses was carried out using the Kraken2 program.
Results: A total of 20 RNA and 20 DNA viral families were detected. Zoonotic RNA families identified in rodents included Peribunyaviridae, Hantaviridae, Flaviviridae, Coronaviridae, Orthomyxoviridae, Paramyxoviridae, Retroviridae, Picornaviridae, Arenaviridae, Togaviridae, and Tobaniviridae. The zoonotic DNA families detected in rodents were Adenoviridae, Poxviridae, Herpesviridae, Anelloviridae, and Circoviridae. Peribunyaviridae and Hataviridae were identified in both humans and rodents. Unclassified +ssRNA viruses were found in dogs and humans. Herpesviridae was present in all three hosts. When compared to dogs and humans, rodents harbored zoonotic viruses that pose a significant public health safety concern.
Conclusion: The study unveiled a noteworthy pattern where the majority of RNA and DNA viruses with zoonotic potential were detected in wild rodents, as opposed to dogs and humans. These findings underscore the pivotal role played by wild rodent populations in the transmission and maintenance of such viruses
Exploring the determinant of flu vaccine hesitancy among Turkish population: a cross-sectional study
Get PDFBackground: Although influenza is a contagious and widespread viral disease, its impact on public health is controlled by vaccination programs. However, anti-vaccination sentiment is also increasing in society. This study aims to explore the factors influencing influenza vaccine hesitancy.
Methods: Between November 2020 and January 2021, a cross-sectional observational survey was carried out in Turkey. To investigate the extent of vaccine hesitancy among individuals, an online questionnaire was created using Google Forms. Data were collected using an exponential non-discriminative snowball sampling technique. Besides internal consistency reliability, chi-square was performed. Statistical significance was defined as p < 0.05.
Results: This research encompassed a cohort of 172 respondents, with an average age of 53.5±14.3 years within the total sample. Most participants (126, 73.25%) were above 45. The participant group was predominantly female (93, 54.1%), and most had achieved a high school or university education (117, 66.2%). Out of the participants, 123 individuals (71.5%) reported having a chronic ailment. Among the 172 participants, 118 (68.6%) exhibited no reluctance to receive the influenza vaccine, while 54 (31.4%) expressed vaccine hesitancy. There was a notable statistically significant distinction in the level of knowledge regarding influenza vaccines (p<0.001, χ²= 20.482).
Conclusion: Lack of information, perceived harms, lack of trust in pharmaceutical companies, and experiences are among the most important determinants of anti-vaccination. Pharmacists may have a potential role in the leading part of the healthcare team in the fight against anti-vaccination in the community
Bridging the diagnostic gap: liver function tests and IL-6 as potential early predictors of non-alcoholic fatty liver disease in psoriasis
Get PDFBackground: Psoriasis goes beyond skin, intertwining with body systems, notably connecting to nonalcoholic fatty liver disease (NAFLD). This study aims to explore the predictive potential: liver function tests and IL-6 as early markers for non-alcoholic fatty liver disease in psoriasis patients.
Methods: From March to November 2023, a case-control study was performed at the dermatological outpatient clinic of Baquba Teaching Hospital, Iraq. Individuals with confirmed psoriasis and those without underwent comprehensive clinical history and overall health examinations. The diagnosis of non-alcoholic fatty liver disease (NAFLD) was established using the Fatty Liver Index (FLI).
Results: Among the 290 participants in this study, 103 with confirmed psoriasis displayed a Fatty Liver Index (FLI) score >60, indicative of non-alcoholic fatty liver disease (NAFLD). The control group, comprising 101 individuals without psoriasis or NAFLD, provided a baseline for comparison. The mean ages were 32.5 ± 16.2 and 31.5 ± 14.3 years for the case and control groups, respectively. Notably, the case group exhibited significantly higher mean ± SD levels of ALT and AST (61 ± 29 vs. 33 ± 17 U/L, p < 0.0001) and (55 ± 27 vs. 25 ± 15 U/L, p < 0.0001), respectively. Moreover, FLI criteria were markedly elevated in the case group (p = 0.0007, p = 0.0005, p < 0.0001, and p < 0.0001, respectively), and IL-6 levels were significantly higher (p = 0.0003).
Conclusion: The results proposed that liver function tests and IL-6 could act as early predictors for the detection of non-alcoholic fatty liver disease among individuals grappling with psoriasis
Seroprevalence of leptospirosis among hospitalized febrile patients in Unguja Island
Get PDFBackground: Leptospirosis is one of the neglected causes of febrile illness and death in developing countries, including Tanzania. The study aims to determine the seroprevalence of leptospirosis among hospitalized febrile patients in Unguja Island.
Methods: A cross-sectional study was carried out in the three selected hospitals in Unguja Island between January and March 2022. A total of 402 participants with febrile illness were enrolled in the study, and blood samples were collected for sera preparation. Microscopic agglutination test (MAT) was used to detect antibodies against five Leptospira serovars, including Sokoine, Lora, Pomona, Grippotyphosa, and Hebdomadis. All sera samples reacted with MAT titers≥1:160 were counted as positive, MAT titers ranging from 1:20 to 1:80 were counted as exposed to Leptospira bacteria while the absence of agglutination was regarded as negative. The data was analyzed using SPSS version 26, 2019. Descriptive and logistic regression was performed, and p≤0.05 was considered statistically significant.
Results: The mean age of study participants was 29.62 ±16.34, with a range of 0 days to 80 years. Most of them were females (64.2%) and unemployed (67.9%). The overall seroprevalence of leptospirosis was 7.7% (95% CI: 5.3-10.8). Females were 1.016 times higher likelihood to have leptospirosis (AOR = 1.016, 95% CI: 0.47-2.185, p = 0.968). Participants aged 18-35 were 2.093 times more likely to be infected with leptospirosis (AOR= 2.093, 95% CI: 0.835-5.250, p = 0.115). Participants who were unemployed (AOR = 1.169, 95% CI: 0.522-2.615, p = 0.704) revealed a significantly higher likelihood of being infected with leptospirosis. The predominant Leptospira serovars circulating among febrile patients were Sokoine 44 (10.9%), Lora 25 (6.2%), Grippotyphosa 20 (5.0%), Pomona 10 (2.5%), and Hebdomadis 9 (2.2%).
Conclusion: Leptospirosis is a public health threat among febrile patients in Unguja Island; therefore, it’s important to be considered in the differential diagnosis of non-malaria febrile patients for early prevention and control strategies
A study of risk factors for breast cancer in Al-Anbar province: a case- control study
Get PDFBackground: Globally, breast cancer is a widespread malignancy among women, ranking as the second leading cause of female mortality. This study investigates risk factors for breast cancer in AL-Anbar province, Iraq, emphasizing their significance in disease development.
Methods: An investigation was carried out at Al-Anbar Cancer Center in Al-Anbar province, Iraq, employing a case-control design. The study comprised 60 confirmed breast cancer cases and 120 controls without breast issues. Data was collected through direct interviews using a semi-structured questionnaire, and subsequent analyses included descriptive, bivariate, and multivariate approaches.
Results: About 48.0% aged 41-49, and 25% aged 50-59. Case and control groups were matched in age, but varied in marital, education, occupation, menopausal status. Women with benign breast diseases have a 1.7 times higher breast cancer risk (OR=1.7, CI=0.063-4.53). Positive family history triples the risk (OR=3, CI=1.21-7.80, P=0.002), and the sedentary lifestyle exhibits 5 times higher risk of breast cancer (OR=5.67, CI=2.89-4.13, P < 0.001). Menstrual age, parity, and reproductive factors influence breast cancer risk. Menarche at ≤12 years triples the risk (OR=3.05, CI=1.82-5.05, P<0.001), while menarche at ≥16 decreases it (OR=0.89, CI=0.06-5.12, P<0.001). Nulliparity increases risk 2.1 times (OR=2.1, CI=0.8-4.89, P=0.002), and more live births provide significant protection. Preterm delivery before the eighth month triples the risk (OR=2.9, CI=1.32-6.53, P=0.002). Multiple children prevent breast cancer, while mother\u27s age at first full birth ≥30 raises the risk 3.5 times (OR=3.4, CI=1.45-7.88, P=0.014). Women who never breastfed had a significant twofold higher risk of breast cancer (OR=2, CI=0.8-4.38, P=0.003). Postmenopausal women at ≥50 years faced a threefold higher risk than their counterparts (OR=3.25, CI=1-1.11, P=0.004). Hormonal use showed a marginal risk increase (OR=1.2, CI=0.5-1.8, P<0.001).
Conclusion: Breast cancer susceptibility arises from diverse factors like genetics, nutrition, environment, and lifestyle. Effectively managing and preventing breast cancer involves implementing strategic control measures.
Seropositivity of Leptospira in rodents, shrews, and domestic animals in Unguja, Tanzania
Get PDFBackground: Leptospirosis is one of the most commonly neglected zoonoses in developing nations including Tanzania. This study aims to find out the seroprevalence of leptospirosis in rodents, shrews, and domestic animals in different regions in Unguja Island, Tanzania.
Methods: A cross-sectional study was carried out from January to April 2022. The blood samples were collected from rodents and shrews (n=248), cattle (n=247), goats (n=130), sheep (n=32), and dogs (n=80). The blood samples were allowed to clot in a slanted position and serum samples were harvested. A microscopic agglutination test (MAT) was performed on the sera to check for leptospiral antibodies using five Leptospira serovars as antigens (Sokoine, Lora, Pomona, Grippotyphosa and Hebdomadis).
Results: The overall seropositivity of leptospiral antibodies was 9.68% in rodents and shrews, 14.57% in cattle, 10.01% in goats, 31.25% in sheep, and 26.25% in dogs. The seropositivity of Leptospira varied significantly with animal species (OR=1.9, 95 % CI:1.1-3.3, p=0.03). The most frequently detected serovar was Sokoine (27.89%), followed by Pomona (19.47%), Lora (18.26%), Grippotyphosa (17.98%), and Hebdomadis (8.16%), respectively.
Conclusion: Our study suggests that further research should be conducted to find out factors of high seropositivity of leptospiral in Unguja. Vaccination of domestic animals with vaccines against local Leptospira strains should be encouraged, and rodent control and public awareness should be emphasized
A massive benign prostate delivered intact: a case report
Get PDFBackground: Benign prostatic enlargement (BPH) is an age-related condition. Males above the age of 40 years commonly experience lower urinary tract symptoms (LUTS) related to the progressively growing prostate. BPH is coined by a deterioration in the quality of the patient`s life. Medicines along with advanced surgical procedures may not be suitable for treating oversized prostate glands.
Case presentation: A 84-years-old man presented to the urology clinic with severe LUTS that are getting worse over 2 years. He was never catheterized. Medicinal treatments failed to alleviate the symptoms. He has no past medical or surgical history of significance. Prostate ultrasonography revealed a huge prostate of 340cc. He underwent open prostatectomy and enjoyed an uneventful post-operative hospital stay. Histology showed a benign nodular prostatic hyperplasia.
Conclusion: This case presents one of the largest prostates reported in the literature